Virginia Tech
    • Log in
    View Item 
    •   VTechWorks Home
    • Destination Areas (DAs) and Strategic Growth Areas (SGAs)
    • Destination Areas (DAs)
    • Destination Area: Data and Decisions (D&D)
    • View Item
    •   VTechWorks Home
    • Destination Areas (DAs) and Strategic Growth Areas (SGAs)
    • Destination Areas (DAs)
    • Destination Area: Data and Decisions (D&D)
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    A Model for a Smallpox-Vaccination Policy

    Thumbnail
    View/Open
    MortonModelforSmallpox2003.pdf (108.5Kb)
    Downloads: 241
    Date
    2003-01-30
    Author
    Bozzette, Samuel A.
    Boer, Rob
    Bhatnagar, Vibha
    Brower, Jennifer L.
    Keeler, Emmett B.
    Morton, Sally C.
    Stoto, Michael A.
    Metadata
    Show full item record
    Abstract
    Background: The new reality of biologic terrorism and warfare has ignited a debate about whether to reintroduce smallpox vaccination. Methods: We developed scenarios of smallpox attacks and built a stochastic model of outcomes under various control policies. We conducted a systematic literature review and estimated model parameters on the basis of European and North American outbreaks since World War II. We assessed the trade-offs between vaccine-related harms and benefits. Results: Nations or terrorists possessing a smallpox weapon could feasibly mount attacks that vary with respect to tactical complexity and target size, and patterns of spread can be expected to vary according to whether index patients are hospitalized early. For acceptable results, vaccination of contacts must be accompanied by effective isolation. Vaccination of contacts plus isolation is expected to result in 7 deaths (from vaccine or smallpox) in a scenario involving the release of variola virus from a laboratory, 19 deaths in a human-vector scenario, 300 deaths in a building-attack scenario, 2735 deaths in a scenario involving a low-impact airport attack, and 54,729 deaths in a scenario involving a high-impact airport attack. Immediate vaccination of the public in an attacked region would provide little additional benefit. Prior vaccination of health care workers, who would be disproportionately affected, would save lives in large local or national attacks but would cause 25 deaths nationally. Prior vaccination of health care workers and the public would save lives in a national attack but would cause 482 deaths nationally. The expected net benefits of vaccination depend on the assessed probability of an attack. Prior vaccination of health care workers would be expected to save lives if the probability of a building attack exceeded 0.22 or if the probability of a high-impact airport attack exceeded 0.002. The probability would have to be much higher to make vaccination of the public life-saving. Conclusions: The analysis favors prior vaccination of health care workers unless the likelihood of any attack is very low, but it favors vaccination of the public only if the likelihood of a national attack or of multiple attacks is high.
    URI
    http://hdl.handle.net/10919/79711
    Collections
    • Destination Area: Data and Decisions (D&D) [127]
    • Strategic Growth Area: Policy [58]

    If you believe that any material in VTechWorks should be removed, please see our policy and procedure for Requesting that Material be Amended or Removed. All takedown requests will be promptly acknowledged and investigated.

    Virginia Tech | University Libraries | Contact Us
     

     

    VTechWorks

    AboutPoliciesHelp

    Browse

    All of VTechWorksCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    My Account

    Log inRegister

    Statistics

    View Usage Statistics

    If you believe that any material in VTechWorks should be removed, please see our policy and procedure for Requesting that Material be Amended or Removed. All takedown requests will be promptly acknowledged and investigated.

    Virginia Tech | University Libraries | Contact Us